John Ryan

Current concepts in the imaging of uterine sarcoma

Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors. We herein present a comprehensive review of taxonomy, epidemiology, pathology, imaging findings and natural history of a wide spectrum of uterine sarcomas.

Mucinous neoplasms of the appendix: a current comprehensive clinicopathologic and imaging review.

Abstract Mucinous neoplasms of the appendix are a heterogeneous group of neoplasms ranging from simple mucoceles to complex pseudomyxoma peritonei. Considerable controversy exists on their pathologic classification and nomenclature. Clear understanding of the histopathologic diversity of these neoplasms helps in establishing proper communication between the radiologist, the pathologist and the surgeon. In this article, we present a brief discussion of the current taxonomy and nomenclature of mucinous neoplasms of the appendix followed by a review of their imaging features. Important points including the significance of identifying extra-appendiceal mucin at imaging, the new classification of pseudomyxoma peritonei into low- and high-grade varieties and the significance of simultaneous ovarian and appendiceal neoplasms are highlighted.

Is a Picture Worth a Thousand Words? The Effect of Viewing Patient Photographs on Radiologist Interpretation of CT Studies

DESCRIPTION OF THE PROBLEM The past decade has seen sweeping changes to radiologic practice. Year-onyear increases in CT utilization [1,2] and the introduction of teleradiology [3] have inexorably shifted practice toward rapid reporting of cross-sectional imaging. An unintended effect of these changes has been a perceptible reduction in patient contact, with radiologists becoming increasingly remote from patient care [4,5] and feeling personally detached from patients [6]. To “personalize” the reporting process, the idea of presenting patient photographs to reporting radiologists was investigated in an unpublished study [7]. The authors suggested that radiologists produced longer reports containing more incidental findings, and subjectively reported more meticulously and empathetically, when presented with patients’ photographs. The study attracted considerable media attention and was even included in a published nonfiction book [8]. However, its significance remains unclear, because the incidental abnormalities were not classified in terms of clinical importance, and the findings have not been reproduced elsewhere. The purpose of this study was to assess whether presenting patients’

Abdominal Hemangiomas: A Pictorial Review of Unusual, Atypical, and Rare Types

Hemangiomas are a radiologists dream lesions because they allow a confident diagnosis most of the time. However, within the abdomen, hemangiomas may occur in such atypical locations and can have such unusual features that they cause significant diagnostic dilemma and may end up being excised surgically. The literature is replete with isolated case reports of atypical hemangiomas in the abdominal cavity, and, to our knowledge, so far, there is no comprehensive review. We present, in this article, a pictorial review of a gamut of uncommon hemangiomas and hemangiomatosis syndromes. Knowledge of these rare types can help in limiting diagnostic errors and increase the confidence of radiologists, thus avoiding unnecessary surgeries.

MDCT of abdominopelvic oncologic emergencies

Abstract Acute complications arising in abdominopelvic malignancies represent a unique subset of patients presenting to the emergency room. The acute presentation can be due to complications occurring in the tumor itself or visceral or vascular structures harboring the tumor. Multidetector computed tomography (MDCT) is the investigation of choice in the workup of these patients and enables appropriate and timely management. Management of the complication depends primarily on the extent of the underlying malignancy and the involvement of other viscera. The purpose of this article is to depict the imaging features of these complications on MDCT.

Bilateral adrenal infarction in Crohn's disease

Adrenal infarction is an uncommon cause of adrenal insufficiency. We herein present unique occurrence of bilateral adrenal infarction detected on imaging in a young female with known history of Crohns disease. The patient responded well to steroids and is on follow up. To our knowledge, this is the first case reported in English literature of adrenal infarct associated with Crohns disease as extraintestinal manifestation.

Spectrum of Imaging Manifestations in Non-neoplastic Gastric Pathologies

This article illustrates a wide spectrum of non-neoplastic gastric pathologies on cross-sectional imaging. Salient features of inflammatory, infectious, vascular, traumatic, and miscellaneous conditions of the stomach have been discussed and imaging clues to reach an accurate diagnosis are stressed upon.